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Objective:To evaluate the application value of conventional echocardiography and two-dimensional speckle tracking imaging (2D-STI) in assessing the left ventricular systolic and diastolic functions in patients with restrictive cardiomyopathy (RCM).Methods:Fifteen patients confirmed as RCM by cardiac magnetic resonance imaging or pathological biopsy in Fuwei Cardiovascular Hospital of Yunnan Province from September 2017 to June 2020 were selected. According to left ventricular ejection fraction(LVEF), they were divided into LVEF retention group(LVEF≥50%, 8 cases) and LVEF reduction group (LVEF<50%, 7 cases). Meanwhile, 20 healthy volunteers were selected as the control group. Conventional echocardiography and 2D-STI were used to evaluate left ventricular systolic and diastolic function, including left ventricular end-diastolic diameter (LVEDd), LVEF, mitral valve blood flow spectrum peak E/peak A, peak E deceleration time (EDT), tissue Doppler mitral valve ring average early diastolic peak velocity (e′), E/e′ ratio, isovolumetric relaxation time (IVRT), left atrial volume index (LAVI) and speed of tricuspid regurgitation (TVR), tricuspid annular plane systolic excursion (TAPSE), left ventricular longitudinal strain (LS) and circumferential strain (CS). Then the differences and similarities between the two RCM groups and the control group were compared.Results:There was no significant difference of LVEF between LVEF retention group and the control group ( P>0.05), and LVEF in LVEF reduction group was significantly lower than that in control group ( P<0.05). LVEDd in LVEF retention group was significantly smaller than that of LVEF reduction group ( P<0.05), but was not statistically different from the control group ( P>0.05). Values of E/A, E/e′, LAVI and TVR in LVEF retention group and LVEF reduction group were significantly greater than the control group (all P<0.05), and there was no statistically significant difference between the two RCM groups ( P<0.05). Values of e′, EDT, IVRT and TAPSE in LVEF retention group and LVEF reduction group were significantly lower than the control group (all P<0.05), and there was no statistically significant difference between the two RCM groups (all P>0.05). The global LS and LS of AP4, AP3, and AP2 showed significantly different among the 3 groups (all P<0.05). The global and basal, middle, apical segmental CS in LVEF retention group were significantly larger than those in LVEF reduction group (all P<0.05), but they were not significantly different from the control group (all P>0.05). Conclusions:All patients with RCM show left ventricular diastolic dysfunction in conventional echocardiography, and show gradually reduced left ventricular systolic function and left ventricular remodeling. RCM patients with normal LVEF demonstrate decreased myocardial systolic function, and left ventricular global LS could be used as a sensitive indicator to predict myocardial systolic function.
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Objective To explore the effect of different hyperbaric oxygen treatment (HBOT) on delayed neuropsychiatric sequelae followed carbon monoxide (CO) poisoning (DNS).Methods Patients diagnosed acute carbon monoxide poisoning (ACOP) or DNS due to CO poisoning in the hospital from October 2015 to October 2016 were included.Patients who died of ACOP or in persisting unconsciousness condition were excluded.Information of the patients were retrospectively collected including personal data,clinical features and treatment course of hyperbaric oxygen (HBO).All subjects were divided into two groups,consisting of cases who developed into DNS and who fully recovered,according toclinical symptoms.The differences of personal data,clinical features and treatment course of HBO were compared between the two groups.After adjusting the confounding factors,hyperbaric oxygen treatment program of the two groups were analyzed.Results DNS occurred in 39 patients with acute CO poisoning,while 130 patients were fully recovery.The ratio of patients over 55 years old or with smoking history in the DNS group were higher than that in the good outcome group (82.1％ vs.60.8％,23.1％ vs.10.8％).Patients who awoke from unconsciousness but left cognitive impairment were more likely to develop into DNS (P=0.017).Patients who treated with HBO within the first 24 hours,risk of developing into DNS were decreased(OR=0.14,P＜0.01).At the same time,2 times per day and within the first 24 hours worked also as well.(OR=0.29,P=0.011).Even if patients who were given 2 times a day of HBO but not in the first 24 hours after poisoning,could not reduce the risk of evolving to DNS(OR=0.06,P＞0.05);The proportion of patients in the good outcome group accepted HBO for more than six days after poisoning was higher than that in the DNS group (68.5％ vs.48.7％).After adjusting confounding factors,patients who treated with HBO within the first 24 hours (OR=0.22,95％CI:0.09-0.52),2 times per day(OR=0.30,95％CI:0.10-0.87)and lasted for more than 6 days(OR=0.30,95％CI:0.10-0.87)were in a lower risk of involving to DNS.Conclusions For patients diagnosed ACOP,HBOT began in the first 24 hours,1 or 2 times per day or early sustaining to give HBO for more than 6 days could reduce the risk of DNS.